Caribbean  Cancer  Control  Leadership  Forum  Bridgetown,  Barbados  May  11  –  13,  2015  

Meeting  Report  on  Actions  and  Outcomes        Background    The  Caribbean  Cancer  Control  Leadership  Forum  was  sponsored  by  the  Center  for  Global  Health,  National  Cancer  Institute  (NCI),  USA  in  partnership  with  the  Healthy  Caribbean  Coalition  and  the  American  Cancer  Society.  We  at  NCI   are   very  grateful   for  also  having   the  opportunity   to   collaborate  with   the  Caribbean  Public  Health  Agency,  Cancer  Care  Caribbean,  the  Centers  for  Disease  Control  and  Prevention,  the  North  American   Association   of   Central   Cancer   Registries,   the   Pan   American   Health   Organization   and   the  University  of  Hawaii  in  developing  the  Forum.        Goal  of  the  Cancer  Control  Leadership  Forum  Program      The   goal   of   the   Caribbean   Cancer   Control   Leadership   Forum   Program   is   to   increase   the   capacity   of  participating   countries   to   initiate   or   enhance   cancer   control   planning   and   implementation   through   a  multi-­‐sectoral  approach.  National  Cancer  Control  Plans  comprise  an   important  part  of  a   country's  non-­‐communicable  disease  (NCD)  plan  and  can  help  countries  meet  NCD  targets  outlined  in  the  WHO  Global  NCD  Action  Plan.  A  comprehensive  cancer  control  plan  is  a  strategic  national  cancer  plan  that  is  based  on  data  and  developed  by  diverse  partners,   including  government  and  non-­‐governmental  organizations,  to  guide   efforts   within   a   country   to   decrease   the   burden   of   cancer.   The   Forum   was   an   opportunity   for  countries  and  individual  country  representatives  (ICRs)   in  the  region  to  exchange  experiences  and  ideas  about  creating  and  implementing  comprehensive  cancer  control  plans.    Goal  of  the  Caribbean  Regional  Meeting      An   additional   half-­‐day   session  was   added  on  May  13,   2015   to   explore   regional   collaboration   in   cancer  control  planning.  The  main  purpose  of   the  Caribbean  Regional  Cancer  Control  Strategy  Meeting  was  to  utilize  the  key  leaders  within  the  Caribbean  region  who  had  already  assembled  for  the  Forum  to  develop  recommendations   for  strategic   regional   initiatives   focused  on  cancer  control.  This  meeting  provided  an  opportunity   for   key   leaders   to   identify   specific   cancer   control   challenges   and   issues   that   cut   across   all  countries  within   the   Caribbean   region   and   discuss  which   of   those   challenges  might   be   best   addressed  with   a   regional   approach   and   where   it   is   advantageous   to   share   resources.   Experts   in   the   Caribbean  region  shared  information  on  their  current  regional  initiatives  and  experts  from  two  other  regions  (Latin  America   and   the   Pacific)   shared   examples   of   their   regional   cancer   control   planning   activities   and   how  they  implemented  strategies  to  work  together  on  collaborative  initiatives.  

 

Outcomes    The  outcomes  for  each  Forum  country  team  and  ICR:    

• Increased  awareness  of  the  importance  of  national  cancer  control  planning  and  implementation;  • Enhanced  understanding  of  how  to  develop  and  implement  a  national  cancer  control  plan;  • Development  of  a  written  12-­‐month  action  plan  with   specific   tasks   to   initiate  or  enhance  each  

country’s  national  cancer  control  planning  and  implementation  efforts;  • Completion   of   the   action   plan  within   one   year   of   the   Forum  with   technical   assistance   support  

from  NCI;  • Improved   knowledge   of   how   cancer   control   planning   can   be   used   to   address   needs   in   specific  

areas  such  as  engaging  civil  society,  cervical  cancer  control,  understanding  unique  challenges   in  cancer   control   planning   including   addressing   health   disparities,   and   complementing   non-­‐communicable  disease  planning  efforts.    

 Caribbean  Country  Teams        Bahamas    Team  Members:  Dr.  Wesley  Francis,  Mr.  Terry  Fountain,  Dr.  Tracy  Roberts,  Mrs.  Melissa  Major,    Dr.  Raleigh  Butler    Currently,  the  Bahamas  does  not  have  a  comprehensive  cancer  control  plan  in  place.  The  Bahamas  team  indicated  that  their  main  goals  are  to  build  and  sustain  a  coalition  for  national  cancer  control  planning,  strengthen  their  cancer  data  and  develop  a  National  Cancer  Control  Plan.  Their  current  strengths  include:  a)   readiness   and   full   buy-­‐in   of   the   Ministry   of   Health   (political   will);   b)   motivated   core   group   and  impassioned   stakeholders;   c)   good   resources   to   start;   including   a   strong   foundation   in   diagnosis   and  treatment  to  further  build  upon;  d)  a  strong  hospital-­‐based  registry  to  augment  data  strengthening.  Their  greatest  needs  moving   forward  with   their  priority  actions  are   to  have   the  Ministry  of  Health  empower  the   coalition   to   remain   focused  on  achieving   the  ultimate  goal  of  developing  a  national   cancer   control  plan  that  includes  a  comprehensive  cancer  control  plan  for  data  strengthening.      Country  Team  Priority  Action  Items    1. Build  and  Sustain  a  Coalition  for  National  Cancer  Control  Planning  2. Data  Strengthening  3. Develop  National  Cancer  Control  Plan  

 Barbados    Team  Members:    Dr.  Kenneth  George,  Dr.  Natalie  Greaves,  Dr.  Vikash  Chatrani,  Dr.  Theresa  Laurent,  Dr.  Dorothy  Cooke-­‐Johnson    Barbados  primary  goals  are  to  create  a  comprehensive  national  cancer  control  plan  and  partnership.   In  addition,  the  Barbados  team  created  a  rapid  cancer  action  plan  to  implement  over  the  next  four  months,  which  will  include:    

o HPV  vaccine  uptake  o National  cancer  screening  program  (prostate,  colorectal,  cervical,  breast)  o Palliative  care  for  the  public  sector  

 

o Continue  work  of  tobacco  reform  (policy  ratification)  o Develop  “Cancer  Control  Barbados”  (plan  and  partnership)  

Barbados’s   strengths   lie   in   the   fact   that   they   have   existing   element   of   cancer   control   in   their   NCD  strategic  plan  and  palliative  care  needs  assessment  report  and  they  have  a  population-­‐based  registry  and  access   to   university   academics,   all   of   which   will   help   further   their   efforts   in   national   cancer   control  planning  and  implementation.  The  country’s  greatest  need  is  access  to  planning  and  research  staffs  at  the  Ministry  of  Health,  in  order  to  support  the  process  for  a  cancer  control  plan  development.  They  also  need  access  to  the  policy  process  for  implementing  the  action  plan  via  the  Ministry  of  Health.  In  addition,  they  need  to  increase  the  output  from  their  national  cancer  registry  to  inform  the  plan.  Lastly,  they  will  need  to  train  staff/human  resources  to  implement  the  plan.    

 Country  Team  Priority  Action  Items      1. Develop  a  comprehensive  national  cancer  control  plan  and  partnership  2. Develop  a  rapid  action  plan  for  cancer  control  in  Barbados  

 Belize    Team  Members:    Dr.  Byron  Simmons,  Dr.  Beatriz  Thompson  and  Mrs.  Laura  Longsworth      In   January   2013,   Belize   drafted   a   comprehensive   national   cancer   control   plan.   The   priority   actions   the  Belize   team   identified   during   the   Forum   are   as   follows:   a)   establishing   a   clearly   defined   shareholder  partnership;   b)  move   forward  with   a   cancer   registry;   and   c)   identifying   a   focal   person   for   the  national  cancer   plan.     In   order   to   further   their   efforts   in   national   cancer   control   planning   and   implementation,  Belize   will   build   on   their   existing   national   cancer   program   template,   use   their   electronic   countrywide  information  system  as  a  platform  for  a  national  cancer   registry  and  capitalize  on   their   large  number  of  private   pathologists   and   their   functional   cancer   center.   To   move   forward   with   their   priority   actions,  Belize  will  need  to  improve  their  cancer  data  and  lobby  to  make  cancer  a  mandatory  reportable  disease.      Country  Team  Priority  Action  Items    1. Form  and  activate  a  core  group  of  partners  2. Improve  transparency  in  communicating  with  partners  3. Work  towards  development  of  population-­‐based  cancer    Jamaica    Team  Members:    Dr.  Tamu  Davidson  Sadler,  Dr.  Carol  Lord,  Dr.  Nadine  Williams,  Mrs.  Yulit  Gordon  and  Prof.  Horace  Fletcher      In   2013,   Jamaica   developed   the   National   Strategy   and   Action   Plan   for   the   Prevention   and   Control   of  Cancer  through  a  series  of  stakeholder  consultations,  which  was  further  developed  by  a  National  Cancer  Technical  Working  group.  The  Jamaica  team  identified  the  following  priority  actions  upon  their  return  to  Jamaica:   a)   establish   a   Jamaica   National   Cancer   Control   Task   Force;   b)   improve   communication   to  stakeholders  and   the  public   about   the   Jamaica  National  Cancer  Control  Plan;   and  c)  discuss  needs  and  improvements   in   the  registry   regarding  staff  certificates/certification.   In  addition  to  having  the   Jamaica  National   Cancer   Plan,   the   existing   partnerships   with   public,   private,   civil   society   and   academia  stakeholders   are   strengths   the   team   will   build   on   to   further   their   efforts   in   national   cancer   control  

 

planning  and  implementation.    Jamaica’s  greatest  needs  moving  forward  with  their  priority  actions  are  to  address  human  resources  gaps,  put   in  place  sustainable   funding  for  cancer  control  and  assistance  from  country  leaders  to  identify  resources  to  support  the  needs  identified  and  policies  to  support  these  gaps.    Country  Team  Priority  Action  Items    1. Establish  the  Jamaican  National  Cancer  Task  Force  (JNCTF)  2. Increase  Communication  Regarding  the  Jamaican  National  Cancer  Plan  and  Cancer  Control  Efforts  in  

Jamaica  3. Increase  the  Capacity  and  Skills  of  Jamaican  Registry  Staff        Trinidad  and  Tobago    Team  Members:    Dr.  Joanne  Warner,  Mrs.  Nicole  Jordan  and  Mrs.  Sherma  Mills-­‐Serrette      Trinidad  and  Tobago  team  were  unaware  of  any  comprehensive  cancer  control  plan  in   in  their  country.  The   Trinidad   and  Tobago   team   indicated   that   their   goals   are   to:   a)   formulate   a   detailed   report   on   the  Leadership  Forum  for  their  Chief  Medical  Officer  of  Health;  b)  determine  whether  Trinidad  and  Tobago  has   an   existing   cancer   control   plan;   and   c)   research   and   review  national   cancer   control   plans   that   are  available   on   the   ICCP  website   (www.iccp-­‐portal.org).   In   order   to  move   forward  with   these   efforts,   the  Trinidad  and  Tobago  team  will  continue  building  a  stronger  relationship  between  the  Ministry  of  Health  and  Trinidad  and  Tobago  Cancer  Society.  The  Trinidad  and  Tobago  team  also  committed  to  engaging  and  encouraging   the   corporate   community   to   continue   their   support   of   the   Trinidad   and   Tobago   Cancer  Society.  The   team   identified   the   two  major  needs   for  moving   forward  with   their  priority  actions  are   to  implement  the  cancer  control  plan  in  a  timely  manner  and  get  the  national  cancer  registry  functioning.      Country  Team  Priority  Action  Items    1. Increase  Ministry  of  Health  engagement  with  partners  from  civil  society,  academia,  etc.    2. Strengthen  the  national  cancer  registry    3. Strategize  planning  for  the  Trinidad  and  Tobago  Cancer  Society    

   

 Individual  Country  Representatives    Antigua  –  Dr.  Tom  McGowan  Dominica  –  Ms.  Diana  Gittens    Haiti  –  Dr.  Ruth  Damuse  St.  Maarten  –  Ms.  Keoma  La.  Hamer  Suriname  –  Dr.  Els  Dams  and  Ms.  Katherine  Lolley    The   ICRs   spent   significant   time   discussing   their   needs   with   regard   to   cancer   control   planning   and  implementation  with   designated   facilitators.  Many   of   the   ICRs   indicated   that   they   had   increased   their  understanding  of  cancer  control  planning  through  the  Forum  and  were  able  to   identify  areas  for  action  upon  return  to  their  respective  countries.  Each  ICR  developed  their  own  12-­‐month  action  plan  and  some  of  the  action  items  included  engaging  partners  in  other  sectors,  organizing  a  cancer  control  planning  work  groups,   strengthening   knowledge   about   cancer   control   at   home,   and   advocating   for   development   of  national  cancer  control  plans  in  their  countries.